| NPI | 1265649404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA 124702) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209006381) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2013-09-11 |